POS0968 CESAREAN SECTION IN WOMEN WITH SPONDYLOARTHRITIS AND PSORIATIC ARTHRITIS
Authors: C. Skorpen, S. Lydersen, K. Å. Salvesen, M. Wallenius
Journal: Annals of the Rheumatic Diseases (2022)

Background There is sparse documentation on pregnancy outcomes in women with spondyloarthritis (SpA) and psoriatic arthritis (PsA). Data on disease activity is often lacking, preventing the direct investigation of the effect of inflammation on pregnancy outcomes. A cesarean section (CS) implies a higher risk for the mother than vaginal delivery. It delays mobilization after birth necessary to counteract inflammatory pain and stiffness as well as the (re)start of disease modifying medication. Objectives To explore the possible association of disease activity (inflammation) and occurrence of cesarean section in women with SpA and PsA. Methods Data from the Medical Birth Registry of Norway (MBRN) were linked with data from RevNatus, a nationwide observational register recruiting women with inflammatory rheumatic diseases. Singleton births in women with SpA and PsA included in RevNatus 2010 to 2019 were cases. All other singleton births registered in MBRN during this time served as population controls. Results CS occurred more frequently in both SpA (21.9%) and PsA (29.4%) compared to population controls (15.6%), with even higher frequencies in active SpA (23.5%) and active PsA (30.1%). Women with SpA had higher risk for elective CS (risk difference 4.1%, 95% CI 1.4% to 7.9%, p=0.002), while women with PsA had higher risk for emergency CS (risk difference 9.8%, 95% CI 3.8% to 17.6%, p&lt;0.001) as compared to population controls. Conclusion Women with SpA and PsA had increased odds for elective and emergency CS, respectively. Further analysis will explore the role of active inflammation. References [1]Mørk, S et al. Spondyloarthritis and Outcomes in Pregnancy and Labor: A Nationwide Register-Based Cohort Study. Arthritis Care Res (Hoboken). 2021 Feb;73(2):282-288 Table 1. Characteristics of population controls, total patient groups and patient active disease groups, reported as n (%) unless specified as mean (SD ) Characteristic Population controls Spondylo arthritis SpA SpA active BASDAI≥4 Psoriatic Arthritis PsA PsA active DAS28&gt;2.6 Number singleton births 2010 - 2019 575 798 319 115 126 29 Maternal age (years), mean (SD) 30.6 (5.1) 31.7(4.3) 1 31.8 (4.3) 32.0 (4.7) 4 31.8 (4.4) &lt;35 460 720 (80.0) 242 (77.6) 89 (78.1) 87 (71.9) 20 (74.1) ≥35 115 077(20.0) 70 (22.4) 25 (21.9) 34 (28.1) 7 (25.9) Parity No children 244 354 (42.4) 141 (45.2) 43 (37.7) 48 (39.7) 10 (37.0) ≥ 1 child 331 444 (57.6) 171 (54.8) 71 (62.3) 73 (60.3) 17 (63.0) Smoking in pregnancy 34 237 (6.7) 19 (6.3) 10 (9.3) 9 (7.1) 5 (20.0) BMI first trimester, mean (SD) 24.4 (4.8) 25.1 (5.0) 26.5 (5.8) 26.9 (5.6) 5 28.8 (4.9) Cesarean section, CS 89 840 (15.6) 70 (21.9) 2 27 (23.5) 37 (29.4) 6 9 (31.0) Elective 32 114 (5.6) 31 (9.7) 3 15 (13.0) 12 (9.5) 2 (6.9) Emergency 57 691 (10.0) 39 (12.2) 12 (10.5) 25 (19.9) 7 7 (24.1) Earlier caesarean section 55 992 (9.7) 32 (10.0) 16 (13.9) 15 (11.9) 3 (10.3) Disease activity Inactive 3rd trim na 134 (53.8) na 67 (69.8) na Active 3 rd trim na 115 (46.2) 115 29 (30.2) 29 1-7 Group compared to population controls 1 p&lt;0.001 2 p=0.002 3 p=0.002 4 p=0.001 5 p&lt;0.001 6 p&lt;0.001 7 p&lt;0.001 Disclosure of Interests None declared